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Enjoy the Holiday Spirit -- With Moderation.

12/09/2014

Enjoy the Holiday Spirit - With Moderation
Healthy Living - December 9, 2014
William Sturrock, MD

The holiday season is rapidly approaching, and many of us look forward to the festive foods and drink associated with this time of year. From sugar cookies to eggnog, we are all tempted by tasty traditional treats at home and at the workplace. Now we know about watching the sweets and rich desserts, but what about the beverages?

Well it turns out there is a long history of our ancestors partying during this time of year, going back to pre-Christian Europe with drinks like the ‘wassail’. This was a strong mulled cider (or in some areas, ale) consumed by groups of singers going from house to house. Sounds like a lot of fun, but I suspect they didn’t have to worry about getting a DUI or crashing the horse drawn sleigh (horses usually had better sense to avoid danger even if their driver was tipsy).

Which brings us to the subject of this post: What is safe and responsible alcohol consumption? First, let’s state right off that for some people even one drink of alcohol is too much. Generally those who should not drink at all have found out the hard way, with previous alcohol-fueled injuries, legal entanglements, or worse. Serious and dangerous behaviors, to include fights, domestic and sexual abuse, vandalism and other crimes are much more likely to occur in the setting of excess alcohol consumption by individuals who might otherwise not cross these social boundaries. The National Institute on Alcohol Abuse and Alcoholism estimates that the cost of damage to health and property runs over $250 billion a year. To put this in perspective, this amounts to $1.90 for every drink consumed in the US and is over twice the annual budget of the Dept. of Homeland Security!

So, how can we avoid the negative results of excess drinking? Surely a return to Prohibition is not the right answer (we already tried that, remember?). And besides, most of us have enjoyed the sense of relaxation that can lead to lively conversation and social engagement when alcohol is consumed in moderation. To understand moderation, let’s look its opposite: The CDC defines excessive or binge drinking at that which results in a blood alcohol level of over 0.08, which is when judgment may become impaired, coordination disrupted and reflexes slowed. Not to mention that damaging effects to the nervous system and liver are more likely to begin at this level.

Well, most of us don’t attend the office Christmas party with a breathalizer, so how would we know we might be approaching the danger zone? Metabolic studies show that this level is reached when most men consume more than 5 drinks and most women consume more than four (A drink is 1 oz of distilled liquor, 12 ounces of beer or 5 ounces of wine). Surveys report that while binge consumption is more common in young adults age 18-34, it is still a problem across the entire socioeconomic and age spectrum in the US.

Interestingly it is also a problem in many northern European countries but is much less of a problem in the Mediterranean cultures of southern Europe. Some sociologists have attributed the higher prevalence of unhealthy drinking patterns to cultures that do not introduce teens and young adults to small amounts in family gatherings. A glass of wine with dinner is a part of the daily ritual of many homes in France, Italy and Greece. This is very different from the clandestine consumption by six-pack that many American (and British, German, Scandinavian) teens experience as their early experience with alcohol.

But the bottom line is that all of us who consume alcohol need to monitor our own consumption, just like we learn (hopefully) not to eat the entire birthday cake or bag of Halloween candy in one night. Not only does our physical and mental health depend on it, we will be less likely to say or do something at that office party that we will regret forever.

FAQ

1. If alcohol metabolism varies based on size should smaller or lighter individuals consume less?

Answer: Absolutely, and some individuals who rarely drink also do not induce the liver enzymes that help metabolize alcohol. For these folks, 1 or 2 drinks might be their safe limit…which is not a bad thing considering the price of some of those fancy cocktails!

2. Are their specific groups that need to exercise even more caution with alcohol?

Answer: Definitely. The NIH has determined that there is no safe intake of alcohol during pregnancy. Also, if you are planning to drive or operate machinery alcohol should be off-limits. In addition, individuals with certain psychiatric or medical conditions, or on some medications may be at very high risk even with low amounts of alcohol consumption, and should consult their providers for the best advice. Last, those with a family history of alcohol abuse should exercise caution, as there may be genetic factors that make alcohol much more risky in these groups.

3. Beside binge drinking, are there other patterns of alcohol use that can be dangerous?

Answer: Yes, using alcohol to treat insomnia or anxiety is very dangerous and generally will back-fire by causing more problems by interfering with healthy sleep cycles or emotional stability. And some experts define the regular consumption of over 14 drinks per week (10 for women) as ‘problem’ or ‘heavy’ drinking, which if maintained for long periods will increase the risk of hypertension, liver disease, weight gain (and diabetes), neurologic damage, not to mention adverse effects on your wallet!